De Jesus Orlando, Garcia-Irizarry Heidy L, Castañeda-Torres Edna M
Neurosurgery, University of Puerto Rico, Medical Sciences Campus, San Juan, PRI.
Cureus. 2024 Aug 14;16(8):e66860. doi: 10.7759/cureus.66860. eCollection 2024 Aug.
Blunt traumatic injury to the chest or abdomen can produce injury to the aorta, which can compromise perfusion to the lower spinal cord. This report presents the case of a seat belt-restrained driver who sustained blunt abdominal trauma and progressive paraplegia. The trauma produced an acute occlusion of the abdominal aorta associated with an L4 Chance fracture and multiple bowel injuries. The Chance fracture occurred two levels below the aortic occlusion. The significant aortic atherosclerosis changes in this patient could have triggered the complete occlusion two levels above the fracture. An aortic injury associated with a vertebral fracture represents a severe and potentially lethal condition. Lower limb ischemia in the setting of a blunt abdominal injury could lead to a high diagnostic suspicion of abdominal aortic injury. Treatment of the vascular injury should be performed without delay to prevent or reduce permanent neurological deficits and ischemic injuries.
钝性胸腹部创伤可导致主动脉损伤，进而影响脊髓下段的血供。本报告介绍了一例系安全带的驾驶员，其遭受钝性腹部创伤并逐渐发展为截瘫。该创伤导致腹主动脉急性闭塞，并伴有L4 Chance骨折和多处肠损伤。Chance骨折发生在主动脉闭塞平面以下两个节段。该患者显著的主动脉粥样硬化改变可能引发了骨折平面以上两个节段的完全闭塞。与椎体骨折相关的主动脉损伤是一种严重且可能致命的情况。钝性腹部损伤时出现下肢缺血应高度怀疑腹主动脉损伤。应立即对血管损伤进行治疗，以预防或减少永久性神经功能缺损和缺血性损伤。
